Provider Demographics
NPI:1699173849
Name:CARECHOICE PHARMACY LLC
Entity type:Organization
Organization Name:CARECHOICE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:469-909-6430
Mailing Address - Street 1:813 N JUPITER RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5439
Mailing Address - Country:US
Mailing Address - Phone:469-909-6430
Mailing Address - Fax:469-277-3922
Practice Address - Street 1:813 N JUPITER RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5439
Practice Address - Country:US
Practice Address - Phone:469-909-6430
Practice Address - Fax:469-277-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47960183500000X
TX30060333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty